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Therapeutic Drug Monitoring of Second- and Third-Generation Antipsychotic Drugs—Influence of Smoking Behavior and Inflammation on Pharmacokinetics

Both inflammation and smoking can influence a drug’s pharmacokinetic properties, i.e., its liberation, absorption, distribution, metabolism, and elimination. Depending on, e.g., pharmacogenetics, these changes may alter treatment response or cause serious adverse drug reactions and are thus of clini...

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Autores principales: Moschny, Nicole, Hefner, Gudrun, Grohmann, Renate, Eckermann, Gabriel, Maier, Hannah B, Seifert, Johanna, Heck, Johannes, Francis, Flverly, Bleich, Stefan, Toto, Sermin, Meissner, Catharina
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8230242/
https://www.ncbi.nlm.nih.gov/pubmed/34071813
http://dx.doi.org/10.3390/ph14060514
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author Moschny, Nicole
Hefner, Gudrun
Grohmann, Renate
Eckermann, Gabriel
Maier, Hannah B
Seifert, Johanna
Heck, Johannes
Francis, Flverly
Bleich, Stefan
Toto, Sermin
Meissner, Catharina
author_facet Moschny, Nicole
Hefner, Gudrun
Grohmann, Renate
Eckermann, Gabriel
Maier, Hannah B
Seifert, Johanna
Heck, Johannes
Francis, Flverly
Bleich, Stefan
Toto, Sermin
Meissner, Catharina
author_sort Moschny, Nicole
collection PubMed
description Both inflammation and smoking can influence a drug’s pharmacokinetic properties, i.e., its liberation, absorption, distribution, metabolism, and elimination. Depending on, e.g., pharmacogenetics, these changes may alter treatment response or cause serious adverse drug reactions and are thus of clinical relevance. Antipsychotic drugs, used in the treatment of psychosis and schizophrenia, should be closely monitored due to multiple factors (e.g., the narrow therapeutic window of certain psychotropic drugs, the chronicity of most mental illnesses, and the common occurrence of polypharmacotherapy in psychiatry). Therapeutic drug monitoring (TDM) aids with drug titration by enabling the quantification of patients’ drug levels. Recommendations on the use of TDM during treatment with psychotropic drugs are presented in the Consensus Guidelines for Therapeutic Drug Monitoring in Neuropsychopharmacology; however, data on antipsychotic drug levels during inflammation or after changes in smoking behavior—both clinically relevant in psychiatry—that can aid clinical decision making are sparse. The following narrative review provides an overview of relevant literature regarding TDM in psychiatry, particularly in the context of second- and third-generation antipsychotic drugs, inflammation, and smoking behavior. It aims to spread awareness regarding TDM (most pronouncedly of clozapine and olanzapine) as a tool to optimize drug safety and provide patient-tailored treatment.
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spelling pubmed-82302422021-06-26 Therapeutic Drug Monitoring of Second- and Third-Generation Antipsychotic Drugs—Influence of Smoking Behavior and Inflammation on Pharmacokinetics Moschny, Nicole Hefner, Gudrun Grohmann, Renate Eckermann, Gabriel Maier, Hannah B Seifert, Johanna Heck, Johannes Francis, Flverly Bleich, Stefan Toto, Sermin Meissner, Catharina Pharmaceuticals (Basel) Review Both inflammation and smoking can influence a drug’s pharmacokinetic properties, i.e., its liberation, absorption, distribution, metabolism, and elimination. Depending on, e.g., pharmacogenetics, these changes may alter treatment response or cause serious adverse drug reactions and are thus of clinical relevance. Antipsychotic drugs, used in the treatment of psychosis and schizophrenia, should be closely monitored due to multiple factors (e.g., the narrow therapeutic window of certain psychotropic drugs, the chronicity of most mental illnesses, and the common occurrence of polypharmacotherapy in psychiatry). Therapeutic drug monitoring (TDM) aids with drug titration by enabling the quantification of patients’ drug levels. Recommendations on the use of TDM during treatment with psychotropic drugs are presented in the Consensus Guidelines for Therapeutic Drug Monitoring in Neuropsychopharmacology; however, data on antipsychotic drug levels during inflammation or after changes in smoking behavior—both clinically relevant in psychiatry—that can aid clinical decision making are sparse. The following narrative review provides an overview of relevant literature regarding TDM in psychiatry, particularly in the context of second- and third-generation antipsychotic drugs, inflammation, and smoking behavior. It aims to spread awareness regarding TDM (most pronouncedly of clozapine and olanzapine) as a tool to optimize drug safety and provide patient-tailored treatment. MDPI 2021-05-27 /pmc/articles/PMC8230242/ /pubmed/34071813 http://dx.doi.org/10.3390/ph14060514 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Moschny, Nicole
Hefner, Gudrun
Grohmann, Renate
Eckermann, Gabriel
Maier, Hannah B
Seifert, Johanna
Heck, Johannes
Francis, Flverly
Bleich, Stefan
Toto, Sermin
Meissner, Catharina
Therapeutic Drug Monitoring of Second- and Third-Generation Antipsychotic Drugs—Influence of Smoking Behavior and Inflammation on Pharmacokinetics
title Therapeutic Drug Monitoring of Second- and Third-Generation Antipsychotic Drugs—Influence of Smoking Behavior and Inflammation on Pharmacokinetics
title_full Therapeutic Drug Monitoring of Second- and Third-Generation Antipsychotic Drugs—Influence of Smoking Behavior and Inflammation on Pharmacokinetics
title_fullStr Therapeutic Drug Monitoring of Second- and Third-Generation Antipsychotic Drugs—Influence of Smoking Behavior and Inflammation on Pharmacokinetics
title_full_unstemmed Therapeutic Drug Monitoring of Second- and Third-Generation Antipsychotic Drugs—Influence of Smoking Behavior and Inflammation on Pharmacokinetics
title_short Therapeutic Drug Monitoring of Second- and Third-Generation Antipsychotic Drugs—Influence of Smoking Behavior and Inflammation on Pharmacokinetics
title_sort therapeutic drug monitoring of second- and third-generation antipsychotic drugs—influence of smoking behavior and inflammation on pharmacokinetics
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8230242/
https://www.ncbi.nlm.nih.gov/pubmed/34071813
http://dx.doi.org/10.3390/ph14060514
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